The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015

Abstract

Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital to inform future control planning. However, the effect of malaria interventions across the varied epidemiological settings of Africa remains poorly understood owing to the absence of reliable surveillance data and the simplistic approaches underlying current disease estimates. Here we link a large database of malaria field surveys with detailed reconstructions of changing intervention coverage to directly evaluate trends from 2000 to 2015 and quantify the attributable effect of malaria disease control efforts. We found that Plasmodium falciparum infection prevalence in endemic Africa halved and the incidence of clinical disease fell by 40% between 2000 and 2015. We estimate that interventions have averted 663 (542–753 credible interval) million clinical cases since 2000. Insecticide-treated nets, the most widespread intervention, were by far the largest contributor (68% of cases averted). Although still below target levels, current malaria interventions have substantially reduced malaria disease incidence across the continent. Increasing access to these interventions, and maintaining their effectiveness in the face of insecticide and drug resistance, should form a cornerstone of post-2015 control strategies.

In vitro inhibition of Plasmodium falciparum early and late stage gametocyte viability by extracts from eight traditionally used South African plant species

“…While the benefits of adopting these measures have been evident (Bhatt et al, 2015), unfortunately so too has been the emergence of insecticide resistant mosquitoes (Benelli, 2015;Dai et al, 2015;Edi et al, 2012;Ranson et al, 2011) and drug resistant strains of Plasmodium falciparum parasites Dondorp et al, 2009;Tun et al, 2015). There is thus a dire need to advance the efficacy of these approaches with novel interventions, drugs and insecticides in the fight against this disease.…”

Towards the implementation of malaria elimination policy in South Africa: the stakeholders’ perspectives

“…Despite these gains, malaria continues to be a leading cause of morbidity and mortality in the world, with approximately 214 million annual cases and 438,000 deaths in 2015 [2]. The gains made reflect the decisive steps taken by the international malaria community over the years, including the launch of the Roll Back Malaria (RBM) Movement in 1998, the Abuja Declaration in 2000, the launch of the Eight United Nations (UN) Millennium Development Goals (MDGs) in 2000 and the launch of the Global Malaria Action Plan (GMAP) in 2008 [3,4]. Approximately 663 million clinical cases were averted in endemic areas of Africa between the years 2000 and 2015 [4].…”

“…The gains made reflect the decisive steps taken by the international malaria community over the years, including the launch of the Roll Back Malaria (RBM) Movement in 1998, the Abuja Declaration in 2000, the launch of the Eight United Nations (UN) Millennium Development Goals (MDGs) in 2000 and the launch of the Global Malaria Action Plan (GMAP) in 2008 [3,4]. Approximately 663 million clinical cases were averted in endemic areas of Africa between the years 2000 and 2015 [4]. Between 2000 and 2010, the global malaria incidence and deaths decreased by 17% and 26%, respectively [1,5].…”

“…Between 2000 and 2010, the global malaria incidence and deaths decreased by 17% and 26%, respectively [1,5]. In endemic areas of Africa, the incidence of clinical cases decreased by 40% between 2000 and 2015 [4]. Globally, about 109 countries are now free from malaria, but 67 are still malaria endemic with 34 poised to eliminate malaria over the 2013 to 2035 period [5–8].…”

Profile of William C. Campbell, Satoshi Ōmura, and Youyou Tu, 2015 Nobel Laureates in Physiology or Medicine

“…Even with 40-50 years of hindsight since the discovery of these two drug classes, it is difficult to quantify their impact precisely in terms of millions lives saved, and cases of blindness and other misery averted. A recent analysis estimated that in Africa alone, artemisinin combination therapies have averted 146 million malaria cases since 2000 (30). Nobel Prizes are rarely scored by impact, but were there ever to be a popular vote, this year's Prize in Medicine would be outranked by few others.…”