![]() This map is intended as a visual aid only online sources of country-specific malaria risk are provided in “Additional Resources.” Reproduced, with permission, from the Committee to Advise on Tropical Medicine and Travel, Health Canada. Drug resistance is represented by the shaded areas (see legend). In Mexico, Central and South America, the Mediterranean, Asia and Oceania, both P. This species also predominates in Haiti and the Dominican Republic. Over 90% of all malaria cases occur in Africa, and most are caused by P. 1), the majority of which contain drug-resistant strains ( Table 1). Malaria is present to varying degrees in 105 countries ( Fig. Plasmodium vivax, Plasmodium ovale and Plasmodium malariae cause less severe disease. ![]() The majority of cases and almost all deaths are caused by Plasmodium falciparum. Only 4 of the over 100 species of plasmodia are infectious to humans. Plasmodia species are the parasites responsible for malaria. In Canada and other developed nations, malaria is an imported disease and a significant but preventable cause of morbidity and mortality in travellers to endemic areas. However, all age groups may be at risk of severe disease during malaria epidemics, which occur either when changes in the physical environment (caused by climatic variation, agricultural projects or mining, for example) increase the capacity of mosquitoes to transmit the disease or when population displacements (natural disasters, war) expose nonimmune populations to infection. 2 In addition to children, pregnant women (particularly primigravidae) and nonimmune people (e.g., travellers, foreign workers) are at highest risk of severe disease. Malaria disproportionately affects the poor, in whom higher morbidity and mortality can be largely attributed to lack of access to effective treatment 60% of malaria deaths worldwide occur in the poorest 20% of the population. 3 Ninety percent of deaths occur in sub-Saharan Africa, the majority involving children less than 5 years of age. 3 Exact numbers are unknown, but an estimated 300 to 500 million cases and 1.5 to 2.7 million deaths occur each year. Over 40% of the world's population live in malaria-endemic areas. Malaria is one of the most prevalent human infections worldwide. Additional approaches to malaria control, including genetic manipulation of mosquitoes and malaria vaccines, are areas of ongoing research. Prompt evaluation of the febrile traveller, a high degree of suspicion of malaria, rapid and accurate diagnosis, and appropriate antimalarial therapy are essential in order to optimize clinical outcomes of infected patients. For travellers to malaria-endemic regions, personal protective measures and appropriate chemoprophylaxis can significantly reduce the risk of infection. Targeted chemoprophylaxis and use of insecticide-treated bed nets have been successful in some endemic areas. Current efforts to control malaria focus on reducing attributable morbidity and mortality. In endemic regions, malaria is a significant cause of morbidity and mortality and creates enormous social and economic burdens. ![]() Although relatively uncommon in developed countries, where the disease occurs mainly in travellers who have returned from endemic regions, it remains one of the most prevalent infections of humans worldwide. Malaria is a parasitic infection of global importance. ![]()
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