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January 17, 1996

Malaria, the Submerged Disease

Author Affiliations

From the UNDP/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland (Drs Olliaro and Cattani), and the Department of Tropical Public Health, Harvard School of Public Health, Boston, Mass (Dr Wirth).

JAMA. 1996;275(3):230-233. doi:10.1001/jama.1996.03530270070034

MALARIA is one of the major infectious diseases in the world today despite years of efforts first to eradicate it and subsequently to reduce its impact on mortality and morbidity. Plasmodium falciparum, the most virulent of the four human Plasmodium species causing malaria, is potentially life-threatening, increasing in prevalence and becoming even more resistant to in-use drugs.

The World Health Organization (WHO) estimates that there are 300 million to 500 million people infected with malaria.1 The Global Burden of Disease study, used as an input into the World Bank's 1993 World Development Report,2 estimated 805 300 deaths due to malaria in sub-Saharan Africa in 1990, compared with 887100 for diarrheal disease, 1 028 800 for all respiratory infections, and 472 000 for measles.3 The true impact of malaria on mortality is likely to be underestimated in these figures, since a randomized trial of the use of insecticide-impregnated