Poorest children twice as likely to catch malaria

Mosquito nets can protect at-risk children from malaria. Flickr: YoHandy

About half of the world’s population are at risk of contracting malaria. In 2011, there were 26m reported cases and more than 100,000 deaths. Children are especially vulnerable though the disease is both preventable and curable.

But a new study has found that poorer children within the same community are twice as likely to catch the disease.

The research, led by experts from Durham University and the London School of Hygiene and Tropical Medicine (LSHTM), trawled 4696 studies into malaria to find 15 with the right information to compare the odds of children aged under 15 from different socio-economic backgrounds catching malaria. All the children studied were considered to be from impoverished communities but there was a gap between the poorest and the “least poor”.

Durham University’s Professor Steve Lindsay, one of the co-authors of the study, said that the least poor households generally had “better educated parents, greater quality of housing, better access to treated bed nets and anti-malarials and improved nutritional status”.

These factors made a huge difference to a child’s susceptibility to malaria. “Our analysis represents a comparison of the poorest and least poor children within highly impoverished communities, so the two-fold difference in malaria risk between these children is striking,” co-author Lucy Tusting from LSHTM said. “If the analysis were extended to include children from wealthier homes elsewhere, the discrepancies in malaria risk would likely be even greater”.

A single mosquito bite can transfer the parasite Plasmodium into the bloodstream which causes fever and vomiting 10 to 15 days after the bite. If untreated, the parasite can affect the function of vital organs, starting with the liver, and can eventually causes death.

Financial support from wealthy Western countries like the UK and the US has been essential to efforts to control malaria. But “donor fatigue” due to the financial crisis in the west which could create a grave risk of a resurgence of malaria, Lindsay said. In 2011, US$2.3 billion was made available to fight malaria, but Tusting said the amount needed was closer to US$5.1 billion a year.

Cheaper insecticide-treated mosquito nets and indoor insecticide sprays are commonly used to prevent the spread of the disease by cutting down people’s exposure to mosquitoes. Anti-malarial medicines are also administered to those at risk, usually pregnant women and infants.

But problems with large-scale resistance to anti-malarial drugs are looming on the horizon and there are worries that mosquitoes are becoming immune to common insecticides. But experts said the most pressing issue is still a lack of funding.

The study suggests more efforts need to be made to improve the lives of the poorest in communities as a more sustainable way of reducing malaria. The researchers said that while they were not recommending current efforts be put to one side, they encouraged “increased investment in … to support socioeconomic development … since such interventions could prove highly effective and sustainable against malaria in the long term.”

Tustings also called for more co-operation. In Khartoum, in the Sudan, for example, the Ministries of Education, Public Works and Agriculture work together with the Ministry of Health to prevent the disease. One initiative is to ensure that irrigation canals are well maintained and dried periodically to reduce breeding sites for mosquitoes.

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