An additional 11,000 deaths due to malaria may have occurred in 2014 because of disruptions in healthcare services caused by the Ebola outbreak in West Africa, according to a British study published April 23 in The Lancet Infectious Diseases. Another 3,900 deaths may have been due to interrupted delivery of insecticide-treated sleeping nets.
“The ongoing Ebola epidemic in parts of West Africa largely overwhelmed already fragile healthcare systems in 2014, making adequate care for malaria impossible and threatening to jeopardize progress made in malaria control and elimination over the past decade,” study author Patrick Walker of the MRC Centre for Outbreak Analysis and Modelling at Imperial College London said in a news release.
Researchers estimated the effect that cessation of usual healthcare provision for malaria as a result of the Ebola epidemic has had on malaria transmission, case numbers and deaths. Thereafter, they assessed the benefit of a mass drug administration campaign initiated in 2015 to reduce malaria-attributable deaths and fever on the health systems in the three affected countries.
Researchers suggested that if malaria care ceased because of the Ebola epidemic, untreated malaria cases would have increased by 45% in Guinea, 88% in Sierra Leone, and 140% in Liberia in 2014, equating to 3.5 million additional untreated cases with 10,900 malaria-attributable deaths.
They suggested distribution of drugs and insecticide-treated nets timed to coincide with the 2015 malaria transmission season, typically May and June. “Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems,” researchers wrote.
Findings suggested the number of malaria deaths caused by the Ebola outbreak in West Africa were similar to the number of Ebola deaths. Close to 10,900 people have died from Ebola in West Africa as of April 19, according to the World Health Organization.
“If usual healthcare provision remains disrupted throughout 2015, we predict 46,400 further deaths from malaria across the three countries compared with an estimated 31,800 deaths if health systems return to function at the level before the Ebola epidemic,” the authors wrote.
Measures must be taken to prevent malaria infection, such as the WHO-recommended emergency mass drug distribution.
“The near cessation of malaria control could lead to a resurgence in malaria cases and deaths, reversing progress made over the past decade,” researchers stated in the study. “An increase in malaria prevalence will also increase the number of people who have fever-like symptoms, further complicating the identification and treatment of people with Ebola virus disease.”
Researchers pointed to an accompanying U.S. Centers for Disease Control and Prevention editorial which said that if an effective disease surveillance workforce is implemented, “healthcare systems will be strengthened so that the next global health threat will be detected, reported, and contained quickly.”
To comment, email [email protected]