ABSTRACT
Although the commonly quoted incidence of malaria infection is around 300 million cases per year, it is estimated that well over 2 billion febrile episodes resembling malaria occur annually, and a substantial proportion of these are parasitaemic (Breman, 2001). Ninety percent of these cases are in Africa (Breman, 2001). In spite of malaria control programs and the efforts of Roll Back Malaria, the estimated burden of disease due to malaria increased from 39.27 million disability-adjusted life years (DALYs) in 1999 to 42.28 DALYs in 2001 (WHO, 1999,2002). Estimated global malaria mortality increased slightly from 1.110 million in 1998 to 1.124 million in 2001 (WHO, 1999, 2002). In certain parts of Africa, malaria mortality has increased two-to threefold since the late 1980s, in tandem with the spread of chloroquine resistance (Trape, 2001). Malaria mortality rates have substantially decreased in most of the world since 1900, but in subSaharan Africa, although mortality halved between 1900 and 1970, it has increased again from 107 per 105 in 1970 to 165 per 105 in 1997 (WHO, 1999). Malaria mortality in the under-5 group almost doubled in eastern and southern Africa over the period 1990-1998, compared with 1982-1989 (WHO, 2003). Today, Plasmodium falciparum causes more deaths than any other infectious agent in young African children; in eastern and southern Africa, it is now responsible for almost 40% of these deaths (WHO, 2003).
