Detailed Map of Malaria Mortality Offers Hope of Better Prevention and Control Interview with:

Simon I. Hay, BSc, DPhil, DSc Professor of Global Health University of Washington Director of Geospatial Science Institute for Health Metrics and Evaluation (IHME).

Prof. Simon Hay

Simon I. Hay, BSc, DPhil, DSc
Professor of Global Health
University of Washington
Director of Geospatial Science
Institute for Health Metrics and Evaluation (IHME). Why did you undertake this study?

Response: As malaria control has not been routinely informed by subnational variation of malaria burden, we undertook the study to highlight the potential for high-resolution maps of disease burden to better understand the epidemiology of malaria as well as the contribution of recent control efforts as well as to better inform future malaria control efforts. In your opinion, what are the most important findings?
• There was an overall decrease of 57% in the rate of death from malaria across sub-Saharan Africa.
• We identified high-risk areas that have low coverage of both preventive and treatment interventions, which highlights the potential for more targeted malaria control efforts.
• No other study has estimated malaria mortality across sub-Saharan Africa on a 5 km by 5 km grid.
• This study brings malaria mortality to a novel spatial resolution. Moreover, it combines two rigorous and well respected methodological approaches to answer a timely question: Where does malaria still cause death and how might that burden be alleviated? How do you think this will impact programmatic work on the ground?

Response: Understanding the distribution of malaria deaths on a small geographic scale over time will allow us to measure the effects of malaria control programs, which has huge implications on public health policy, e.g. to better understand what works and doesn’t work. These maps also have the potential to implement more efficient and effective malaria control strategies that take into account the spatial distribution of malaria burden.

Our study also highlights the importance of strategies to prevent both drug and insecticide resistance. These maps show us a few things:
• Where different types of interventions have been implemented
• What effect (or lack thereof) they’ve had
• Which areas require more attention (high mortality)
• Which areas we don’t know a lot about (high uncertainty)
Combining these threads through space and over time can result in powerful interventions. What gaps in our knowledge about malaria did this study identify? Where do we still need more information?

Response: The major gap highlighted is the relative lack of timely, high-quality data on malaria mortality across all countries in sub-Saharan Africa. Sparse and low-quality malaria mortality data in sub-Saharan Africa was a big challenge. What implications does this study have for the way we look at global health trends?

Response: This study shows that understanding mortality and epidemiologic trends at a fine spatial resolution allows for new perspectives. Through our geographic approach, we can provide results in a traditional manner (e.g. number of deaths in a country) while simultaneously being able to look at internal variation at a fine scale. Thank you for your contribution to the community.


Mapping Plasmodium falciparum Mortality in Africa between 1990 and 2015

Peter W. Gething, Ph.D., Daniel C. Casey, B.A., Daniel J. Weiss, Ph.D., Donal Bisanzio, Ph.D., Samir Bhatt, D.Phil., Ewan Cameron, Ph.D., Katherine E. Battle, D.Phil., M.P.H., Ursula Dalrymple, B.Sc., Jennifer Rozier, M.Sc., Puja C. Rao, M.P.H., Michael J. Kutz, B.S., Ryan M. Barber, B.S., Chantal Huynh, B.A., Katya A. Shackelford, B.A., Matthew M. Coates, B.S., Grant Nguyen, B.A., Maya S. Fraser, B.A., Rachel Kulikoff, B.A., Haidong Wang, Ph.D., Mohsen Naghavi, M.D., M.P.H., Ph.D., David L. Smith, Ph.D., Christopher J.L. Murray, M.D., D.Phil., Simon I. Hay, D.Sc., and Stephen S. Lim, Ph.D.
October 10, 2016DOI: 10.1056/NEJMoa1606701

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Last Updated on October 10, 2016 by Marie Benz MD FAAD