Working to secure access to prevention, care and treatment for children most at risk of the most common childhood illnesses
Burden of disease
9.2 million children died before their fifth birthday in 2007 according to UNICEF’s latest figures. Whilst there has been a significant decline in global childhood mortality over the last 30 years, the loss of 26,000 children per day is a tragic and unacceptable figure. Almost half of these deaths occurred in Sub-Saharan Africa and the vast majority were caused by four entirely preventable and curable diseases, namely pneumonia, diarrhoeal diseases, malaria and measles.
Communicable diseases are the major cause of morbidity and mortality among children under five years, especially those living in poor conditions. Children who succumb to illness are forced to miss out on school, damaging their future prospects as well as the future economic health of their societies. Poor families are forced to spend a large proportion of whatever savings they have on treating their loved ones, damaging the whole family’s ability to climb out of the poverty trap.
How is Malaria Consortium helping children to survive?
Malaria Consortium is committed to the control and prevention of communicable diseases that kill and impoverish children. Malaria Consortium works to secure the access of high-risk groups to prevention, care and treatment of malaria and other communicable diseases including diarrhoeal diseases, respiratory diseases and neglected tropical diseases. We strive to improve and support public health services and educate key figures at the community level, key interventions that have been shown to increase childhood survival.
Malaria Consortium recognises the symptom overlap between malaria and pneumonia and is working with partners to expand the home based management of malaria strategy to include diagnosis and treatment of pneumonia. We are also working closely with governments and partners to expand community based strategies to include management of diarrhoeal diseases and implementation of best practices to achieve improvements in child survival. Malaria Consortium always bases its interventions on sound evidence-based research and advocates for the use of best practices.
Malaria Consortium continues to advocate for an increased response to malaria and other childhood illnesses. All Malaria Consortium projects have a health system strengthening component in order to improve overall health service delivery. Malaria Consortium is also committed to extending the delivery of services to hard to reach areas whilst striving to expand community based management of childhood illnesses in Southern Sudan, Uganda, Ethiopia and underserved areas of Mozambique.
Pneumonia, dubbed the ‘forgotten killer of children’, kills more children than any other disease including AIDS, malaria and measles combined, according to the WHO and UNICEF Approximately 2 million children under five years old die each year from pneumonia. In developing countries, pneumonia is mainly caused by a bacterial infection that can be effectively treated with inexpensive antibiotics.
Pneumonia often affects children with low birth weight, compromised immune systems, malnutrition or measles. Without treatment, pneumonia kills quickly. A further problem is that children with pneumonia can exhibit a wide range of symptoms that also mimic malaria or indeed can occur in association with malaria (mixed morbidity), making it essential to treat both diseases. Malaria Consortium has been helping community health workers to address this particular problem and raising awareness of mixed morbidity amongst mothers and older children.
Recent research shows that pneumonia can be treated successfully at the community level with high dose oral antibiotics (relieving the burden on overstretched hospitals). Increasing zinc intake and improving personal hygiene are two more proven preventative measures that have some role in reduction of deaths due to pneumonia, though their main role is in the reduction of morbidity and mortality associated with diarrhea.
A large number of deaths from pneumonia are cased by the pneumoccocus bacterium for which there is also a very effective but very expensive vaccine not widely available in Africa but widely available in the US and Europe. If this vaccine was deployed it would save many lives, particularly as the pneumococcus is increasingly resistant to common antibiotics.
Diarrhoeal diseases cause approximately 1.7 million child deaths each year worldwide, making them the second biggest killer of children under five. Diarrhoeal diseases are caused by ingestion of contaminated water/food or by poor hygiene and sanitation practices. They are most prevalent in areas where people struggle to find safe drinking water for drinking, cooking and sanitation. Untreated diarrhoeal episodes can cause severe dehydration and electrolyte imbalance (loss of essential minerals from the body) resulting in death.
Diarrhoeal diseases can be treated simply and effectively. Given the fact that they are mainly caused by a virus, most diarrhoeal disease do not require antibiotics. Oral rehydration salts (ORS) are one of the most effective ways of ensuring diarrhoeal diseases pass without causing lasting or fatal complications. Zinc has recently been shown to reduce both the duration and number of diarrhoeal episodes, while improving personal hygiene by hand washing prevents a massive 0.5 to 1.4 million deaths per year according to UNICEF. Making communities aware of the effectiveness of hand washing is a key strategy that can guarantee real progress in combating the burden of diarrhoeal diseases.
In the World Malaria Report 2008, an estimated 247 million cases of malaria (2006 WHO figures) led to almost 881,000 deaths, with over 75% of these deaths among African children under five years of age.
Malaria is most often caused by a parasite called Plasmodium, which is transmitted through the bite of an infected female Anopheles mosquito helping herself to a blood meal to nurture her eggs. Malaria accounts for one in five childhood deaths in Africa. Anaemia, low birth weight, epilepsy and neurological problems are the all-too-familiar consequences of malaria in children.
Treating fevers caused by malaria at home has been a successful strategy in reducing malaria deaths amongst African children. Malaria can be easily treated at the community level with the most effective drug being artemisinin combined treatments (ACT) which many countries have made progress in distributing. There remains, however, a need to incorporate differential diagnosis and supply antibiotics alongside anti-malarial drugs in cases of malaria overlapping with pneumonia.
There has been a marked improvement in malaria diagnostics, with easy to use rapid diagnostic tests (RDTs), that give results in 15 minutes, becoming more affordable and available. The use of long-lasting insecticidal nets (LLIN) has likewise proved to be an effective prevention method to combat malaria.
However, due to poor accessibility and availability of health services, unfortunately malaria is often still left untreated and turns fatal very quickly. Educating key community members to recognise symptoms of malaria and be aware of treatments has saved the lives of many children.
Measles is a major killer of young children despite the existence of a safe and cheap vaccine, with 90% of measles deaths in 2005 amongst the under fives.
Measles is a virus that grows in the back of the throat and lungs and is spread by personal contact. While most sufferers make a full recovery, children in countries with low per capita incomes and weak health systems often run the risk of suffering serious complications. When measles strikes young, undeveloped immune systems damaged by malnutrition the result is often fatal.
Knowledge of measles treatment has been improving with the prescription of oral rehydration solutions and Vitamin A supplements proving highly effective in cutting deaths. The most effective weapon remains immunisation with a vaccine costing less than one US dollar. The global health community can take great pride in cutting measles deaths by a dramatic 78 per cent between 1999 and 2007 (according to WHO figures). Continuing to develop access to immunisation, effective surveillance strategies and better treatment should guarantee that many more of the world’s poorest children are spared the threat of measles in the future.
Malaria Consortium does not work in this area.
available for download
malaria control by increasing both supply and
demand for malaria control tools in Uganda
to appropriate treatment for childhood
illnesses at community level