Malaria control has not been routinely informed by the assessment of subnational variation in malaria deaths. We combined data from the Malaria Atlas Project and the Global Burden of Disease study to estimate malaria mortality across sub-Saharan Africa on a grid of 5 km2 from 1990 through 2015.
We estimated malaria mortality using a spatiotemporal modeling framework of geolocated data (i.e., with known latitude and longitude) on the clinical incidence of malaria, coverage of antimalarial drug treatment, case fatality rate, and population distribution according to age.
Across sub-Saharan Africa during the past 15 years, we estimated that there was an overall decrease of 57% (95% uncertainty interval, 46 to 65) in the rate of malaria deaths, from 12.5 (95% uncertainty interval, 8.3 to 17.0) per 10,000 population in 2000 to 5.4 (95% uncertainty interval, 3.4 to 7.9) in 2015. This led to an overall decrease of 37% (95% uncertainty interval, 36 to 39) in the number of malaria deaths annually, from 1,007,000 (95% uncertainty interval, 666,000 to 1,376,000) to 631,000 (95% uncertainty interval, 394,000 to 914,000). The share of malaria deaths among children younger than 5 years of age ranged from more than 80% at a rate of death of more than 25 per 10,000 to less than 40% at rates below 1 per 10,000. Areas with high malaria mortality (>10 per 10,000) and low coverage (<50%) of insecticide-treated bed nets and antimalarial drugs included much of Nigeria, Angola, and Cameroon and parts of the Central African Republic, Congo, Guinea, and Equatorial Guinea.
We estimated that there was an overall decrease of 57% in the rate of death from malaria across sub-Saharan Africa over the past 15 years and identified several countries in which high rates of death were associated with low coverage of antimalarial treatment and prevention programs. (Funded by the Bill and Melinda Gates Foundation and others.)
Emily Haeuser, Laura Dwyer-Lindgren, Simon Hay, Audrey Serfes, Michael Cork, Mingyou Yang, Nicole Weaver, Samath D. Dharmaratne, Kimberly Johnson, Heidi Larson, Tomislav Mestrovic, Ali Mokdad, Jennifer Ross, Maitreyi Sahu
Bobby Reiner, Simon Hay, Katie Welgan, Chris Troeger, Mathew Baumann, Brigette Blacker, Molly Miller-Petrie, Lucas Earl, Daniel Casey, Aubrey Cook, Farah Daoud, Nicole Weaver, Samath D. Dharmaratne, Laura Dwyer-Lindgren, Valery Feigin, Joseph Frostad, Kimberly Johnson, Alice Lazzar-Atwood, Kate LeGrand, Stephen Lim, Paulina Lindstedt, Laurie Marczak, Benjamin Mayala, Tomislav Mestrovic, Ali Mokdad, Jon Mosser, Christopher J.L. Murray, QuynhAnh Nguyen, David Pigott, Puja Rao, David Smith, Emma Spurlock
Joseph Frostad, Bobby Reiner, Simon Hay, Michael Brauer, QuynhAnh Nguyen, Mathew Baumann, Brigette Blacker, Laurie Marczak, Kate LeGrand, Kimberly Johnson, Lalit Dandona, Rakhi Dandona, Samath D. Dharmaratne, Benjamin Mayala, Tomislav Mestrovic, Ali Mokdad, Christopher J.L. Murray, Mohsen Naghavi, Emma Spurlock, Katie Welgan