Definition
Prevalence of malaria is the number of cases of malaria per 100,000 people. Death rates associated with malaria are number of deaths caused by malaria per 100,000 people.
Goal/target addressed
Goal 6. Combat HIV/AIDS, malaria and other diseases.
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.
Rationale
The indicator allows highly endemic countries to monitor disease and death from malaria, which have been increasing over the last two decades due to deteriorating health systems, growing drug and insecticide resistance, periodic changes in weather patterns, civil unrest, human migration and population displacement.
Method of computation
Where the only prevalence data available are reported through the administration of health services, they are expressed per 100,000 population, using population estimates as the denominator.
Where prevalence data on children under five come from household surveys, the data may be reported as percentages of children under five with fever in the last two weeks. The percentage may be multiplied by 1,000 to express the rate per 100,000.
The World Health Organization (WHO) also produces model-based estimates of malaria-specific mortality.
Data collection and source
Data come from administrative sources, household surveys and vital statistics registrations. Administrative data are derived by health ministries from the administration of health services. Multiple Indicator Cluster Surveys collect information on prevalence of fever in the last two weeks for children under five. The surveys also provide data on all causes of under-five mortality.
Vital statistics registration systems collect data on cause of death, including deaths caused by malaria. Good quality information requires that death registration be near universal, that the cause of death be reported routinely on the death record and that it be determined by a qualified observer according to the International Classification of Diseases. Such information is not generally available in developing countries but is now compiled by WHO annually for approximately 70 (mainly developed) countries.
References
World Health Organization, www3.who.int/whosis.
Roll Back Malaria, www.rbm.who.int.
The State of the World’s Children, annual, United Nations Children’s Fund (www.unicef.org/publications).
Africa Malaria Report, 2003, World Health Organization and United Nations Children’s Fund
Gender and Health, Technical Paper, 1998, World Health Organization (www.who.int/reproductive-health/publications).
Periodicity of measurement
Gender issues
Potential differences between men and women are a function of the interaction between biological factors and gender roles and relations. Biological factors vary between men and women and influence susceptibility and immunity to tropical diseases. Gender roles and relations influence the degree of exposure to the relevant vectors and also to access and control of resources needed to protect women and men from being infected. Women’s immunity is particularly compromised during pregnancy, making pregnant women more likely to become infected and implying differential severity of the consequences. Malaria during pregnancy is an important cause of maternal mortality.
Disaggregation issues
All data should be classified by gender, as there could be differential death rates.
Rural populations carry the overwhelming burden of disease, so urban and rural disaggregation of the data is important in tracking the progress made in rural areas. Multiple Indicator Cluster Surveys data have shown substantial difference by wealth quintiles, and where possible the data should be disaggregated by the wealth index.
International data comparisons
World Health Statistics, annual, World Health Organization (www3.who.int/whosis). [Can’t find this publication. Do you mean World Health Report? www.global-health.gov/worldhealthstatistics.shtml]
World Development Indicators, annual, World Bank (www.worldbank.org/data).
Human Development Report, annual, United Nations Development Programme (www.undp.org).
The State of the World’s Children, annual, United Nations Children’s Fund (www.unicef.org/publications).
United Nations Children’s Fund, www.childinfo.org and www.unicef.org.
Comments and limitations
Malaria statistics are reported in countries where it is endemic, which includes almost all developing countries. But data reported by ministries are often only a fraction of the number of cases in the population. Many report only laboratory-confirmed cases. In Sub-Saharan Africa, clinically diagnosed cases also tend to be reported.
Differences between male and female prevalence and incidence rates are difficult to measure since malaria in women is more likely to be undetected. The fact that health services focus almost exclusively on women’s reproductive function means that opportunities are lost for detection of multiple conditions, including tropical diseases. Moreover, when incidence rates in women and men are similar, there are still significant differences between them in the susceptibility and the impact of tropical diseases.
Agencies
Ministries of health.
United Nations Children’s Fund.
World Health Organization.