Prevention and treatment of malaria in young African children.

Malaria remains a major challenge to global public health, with morbidity and mortality rates being highest in African children infected with Plasmodium falciparum . All four species of human malaria may initially present as a nonspecific flu-like illness, whereas P. falciparum infection in nonimmune young children has a tendency to progress rapidly to life-threatening illness. These factors, together with the increasing emergence of multi-drug resistance, pose substantial challenges to current efforts to provide prompt and accurate diagnosis and effective treatment, particularly to the rural poor who are most affected by malaria. Acute episodes of severe malaria, repeated malaria infections leading to severe anemia, and infection during pregnancy which predisposes to low birth weight, a major risk factor for neonatal death, account for the majority of malaria-related deaths in young African children. Improved prevention and control strategies targeted at each of these clinical syndromes have been developed and are reviewed in this article. Coverage of protective measures of known safety and efficacy (insecticide-treated nets, Intermittent Preventive Treatment) remains alarmingly low in most high-burden areas. The growing global commitment to rapidly increase and sustain coverage among the most vulnerable populations, along with renewed investment in research to hasten the development of effective vaccines, antimalarial drugs, and insecticides, provides a unique opportunity to markedly reduce the burden of disease during the current decade.