Preventing malaria in children

Malaria kills a child somewhere in the world every 30 seconds. It infects 350-500 million people each year, killing 1 million, mostly children in Africa. Ninety per cent of malaria deaths occur in Africa, where malaria accounts for about one in five of all childhood deaths. The disease also contributes greatly to anaemia among children — a major cause of poor growth and development.
Malaria infection during pregnancy is associated with severe anaemia and other illness in the mother and contributes to low birth weight among newborn infants, one of the leading risk factors for infant mortality and sub-optimal growth and development.

Malaria has serious economic impacts in Africa, slowing economic growth and development and perpetuating the vicious cycle of poverty. Malaria is truly a disease of poverty — afflicting primarily the poor who tend to live in malaria-prone rural areas in poorly-constructed dwellings that offer few, if any, barriers against mosquitoes.
Malaria is both preventable and treatable, and effective preventive and curative tools have been developed.
Sleeping under insecticide treated nets can reduce overall child mortality by 20 per cent. There is evidence that ITNs, when consistently and correctly used, can save six child lives per year for every one thousand children sleeping under them.

Prompt access to effective treatment can further reduce deaths. Intermittent preventive treatment of malaria during pregnancy can significantly reduce the proportion of low birth weight infants and maternal anaemia.
Unfortunately, many children, especially in Africa, continue to die from malaria as they do not sleep under insecticide-treated nets and are unable to access life-saving treatment within 24 hours of onset of symptoms. Most recent data on household use of insecticide treated nets reveal low coverage rates of only around 5 per cent across Africa. However, recent efforts to scale up coverage have contributed to significant progress in several countries.

Increasing resistance of the malaria parasite to chloroquine and sulphadoxine-pyrimethamine — previously the most widely used antimalarial treatments — has prompted sixty-eight countries to change their national treatment protocols to incorporate the new and highly-effective artemisinin-based combination therapies or ACTs.
There is increasing evidence that where they occur together, malaria and HIV infections interact. Malaria worsens HIV by increasing viral load in adults and pregnant women; possibly accelerating progression to AIDS; and potentially increasing the risk of HIV transmission between adults, and between a mother and her child. In adults with low CD4 cell counts and pregnant women, HIV infection appears to make malaria worse.