The number of people who die each year of malaria in India may be 13 times higher than currently estimated, according to a study published online today in The Lancet . As with all estimates of malaria deaths, however, some researchers are skeptical that the new number is valid.
The report, part of the study of death Million Indian government estimates that some 205,000 Indians under age 70 die each year from the disease. Previous World Health Organization (WHO) reports put the figure at 15,000. But many believe that the WHO number is a gross underestimate because it relies primarily on government and health records. Many malaria deaths occur outside hospitals and are therefore not easily registered. And unlike more prolonged diseases, malaria can strike quickly, which makes it even more difficult to follow.
"Something like malaria, which within 48 hours of a patient can actually be in a coma and on their way, they are much more likely to have missed," said Bob Snow, tropical health researcher Kenya medical research Institute, who was not part of the study.
to try to get a better solution to the balance sheet of malaria, the authors of a team of scientists from India, Canada, the UK and sent surveyors selected Favourite States Random regions in India to collect information on deaths that took place there between 01 and 03. As part of these so-called verbal autopsy, investigators asked families and other witnesses to describe what happened victim. They asked if they had suffered a fever, what kind of fever and other issues that could make the switch off malaria. A total of 130 doctors examined the reports, with two each looking.
When the results came back, 3.6% to 75 000 deaths were attributed to malaria. This translates into 205,000 malaria deaths nationwide each year, according to the study, led by Neeraj Dhingra of the national fight against AIDS organization in New Delhi. Ninety percent occurred in rural areas, and 86% occurred outside of any kind of health facility.
But the new figures could be largely exaggerated, said Robert Newman, director of the Global Malaria Programme of WHO, which notes that the use of oral accounts for diagnosing a disease like malaria is incredibly risk. "For a disease that has achieved something that is very distinctive, say a very distinctive rash or paralysis associated with it, you can make a fairly accurate diagnosis through verbal autopsy," he said. "The problem with malaria are the symptoms associated with malaria, especially fever, are very non-specific. So many deaths had fever associated with are not necessarily malaria."
According to Newman, WHO has tested the accuracy of this verbal autopsy in India before. Just 4% of those who claimed to diagnose malaria actually did. "Malaria remains a major public health problem in India," he said, "but I do not think we're talking about a difference of magnitude."
Although verbal autopsies are "a blunt tool," Snow said he still believes The Lancet The paper estimate is legitimate. This is partly because many deaths from slipping through the cracks of the health information systems of India and partly because, at least in terms of geography, the study of statistics correspond to deaths malaria reported by the State. There is also the fact that India is so huge. "A state in India is several African countries," he said.
Snow said a study like this could force scientists to rethink WHO global statistics of malaria, especially in more heavily populated remote regions such as Myanmar, Bangladesh and Pakistan. Newman said the WHO will continue to work with officials of Indian health and examine their data, but stresses that these are things they do regularly.
Meanwhile, snow hope the Indian government will fight against malaria even greater priority, although the fact that the disease is largely concentrated in rural states may attract less attention she.
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