Malaria accounts for one in five of all childhood deaths in Africa.Anaemia, low birth-weight, epilepsy, and neurological problems,all frequent consequences of malaria, compromise the healthand development of millions of children throughout the tropicalworld. Yet much of the impact of malaria on the world s childrencould be prevented with currently available interventions.

The unacceptable mortality from malaria

Of the more than 500,000 African children who develop cerebral malaria (a severe form of the disease that affects the brain) each year, 20-40% die and approximately 7% are left with permanent neurological damage. Children with malaria typically develop fever, vomiting, headache and flu-like symptoms. If untreated, the disease may progress rapidly (often within 24 hours) to convulsions, coma, and death.

Malaria is a major cause of anaemia in many parts of the world. Chronic anaemia may adversely affect a child’s growth and intellectual development. Repeated episodes of malaria may lead to severe, life-threatening anaemia. Blood transfusions may save lives in these circumstances, but also expose the child to the risk of HIV and other blood-borne infections.

The Roll Back Malaria global partnership is working to reduce illness and death in young children through:

• Prevention: Children must be protected from the mosquitoes that transmit malaria. The best way to do this is to ensure that they sleep under insecticide-treated nets (ITNs). Studies in Africa have shown that ITNs can reduce deaths among under-fives by up to one-third.

• Prompt recognition and effective treatment: There is an urgent need to ensure that effective and affordable antimalarial drugs or drug combinations are widely available to all individuals living in malaria-endemic areas. Since, in Africa, many people first go to their local store for antimalarial drugs, shopkeepers are now being trained to supply the appropriate dose and duration of treatment.

• Anaemia: Parents and healthcare workers must be trained to recognize the clinical signs of anaemia, and to seek treatment. Malaria, nutritional iron deficiency and intestinal parasites (such as hookworm) are the most common and preventable causes of anaemia in much of the developing world.

• Prevention of malaria-related low birth weight: Pregnant mothers must be encouraged to use ITNs and take advantage of Intermittent Preventive Treatment. This has been shown to increase birth weight, a major determinant of child survival.