Hay, Simon, Guerra, Carlos A., Tatem, Andrew J., Atkinson, Peter M. and Snow, Robert W.
Tropical infectious diseases: Urbanization, malaria transmission and disease burden in Africa
Nature Reviews Microbiology, 3, (1), . (doi:10.1038/nrmicro1069).
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Many attempts have been made
to quantify Africa’s malaria burden but none
has addressed how urbanization will affect
disease transmission and outcome, and
therefore mortality and morbidity estimates.
In 2003, 39% of Africa’s 850 million people
lived in urban settings; by 2030, 54% of
Africans are expected to do so. We present
the results of a series of entomological,
parasitological and behavioural metaanalyses
of studies that have investigated
the effect of urbanization on malaria in
Africa. We describe the effect of
urbanization on both the impact of malaria
transmission and the concomitant
improvements in access to preventative and
curative measures. Using these data, we
have recalculated estimates of populations
at risk of malaria and the resulting mortality.
We find there were 1,068,505 malaria
deaths in Africa in 2000 — a modest 6.7%
reduction over previous iterations. The
public-health implications of these findings
and revised estimates are discussed.
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