The economic burden of malaria

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The statistics

Worldwide, there are 109 malaria endemic countries as surveyed in 2008, with 45 of these in Africa. In 2006, 3.3 billion people were at risk of contracting malaria of which 1.2 billion people reside in Africa. Two hundred and forty-seven million people were infected with malaria in 2008 resulting in 1 million deaths, with 91% of these in Africa and 85% due to children younger than 5 years of age (Figure 1.1) (World Malaria Report 2008). In Africa, a child dies every 30 seconds due to the devastating impact of malaria (Greenwood et al., 2005). In eastern Uganda, children can expect to be infected with malaria once every 2 months, even with the use of bednets an  artemisinin combination therapies (ACT’s) (Price, 2000) and in the rest of Africa a child can have an average of 1.6 to 5.4 clinical episodes of malaria fever every year (World Malaria Report 2008).
This is clearly in stark contrast to the Millennium Development Goals (MDG) that were adopted by 189 nations and signed by 147 heads-of-state and governments during the United Nations (UN) Millennium Summit in September 2000. The MDG’s 8 goals include the eradication of hunger and poverty, provision of primary education, gender equality, improved maternal health and reduction in child mortality, to combat various diseases like Human Immunodeficiency Virus (HIV) and malaria, environmental sustainability and finally the development of global partnerships. Of particular interest is MDG goal 6, which aims to reduce malaria infection and mortality, and especially child mortality by 2015.
A global map of endemicity of malaria is lacking since WHO maps only provide estimations of malaria incidence (Figure 1.1). The Malaria Atlas Project (MAP) generated a total of 8938 P. falciparum parasite rate (PfPR) surveys, of which 7953 passed the strict criteria to be included in a global database. This data was captured from 1985 until currently (2010), of which more than 50% of the data is representative from 2000 onward. This database is currently used to predict malaria endemicity and incidence with geographic visualisation (Figure 1.2) (Hay et al., 2009, Guerra et al., 2008, Guerra et al., 2007). In the future, it is aimed to also produce a map on P. vivax endemicity,
but unfortunately data for this is still lacking (Hay et al., 2009).

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CHAPTER 1  Introduction
1.1 The statistics
1.2 The economic burden of malaria
1.3 History of malaria
1.4 Life cycle
1.5 Pathogenesis
1.7 Currently used drugs and drug resistance
1.8 New drug targets
1.9 Polyamines
1.10 The “omics” era
1.11 The use of functional genomics to validate drug targets
1.12 Objective
CHAPTER 2  Proteomic profiling of P. falciparum through improved, semi-quantitative two-dimensional gel electrophoresis .
2.1 Introduction
2.2 Methods
2.3 Results
2.4 Discussion
Chapter 3  Proteome consequences of P. falciparum AdoMetDC inhibition with MDL73811 
3.1 Introduction
3.2 Methods
3.3 Results
3.4 Discussion
CHAPTER 4  Transcriptional responses of P. falciparum to inhibition of AdoMetDC with MDL73811 
4.1 Introduction
4.2 Methods
4.3 Results
4.4 Discussion
Chapter 5Characterisation of specific metabolic responses identified in the transcriptomic and proteomic investigations of AdoMetDC inhibition in P. falciparum
CHAPTER 6  References 

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