HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (2) Google Scholar Articles by Koram, K. A. Articles by Molyneux, M. E. PubMed Articles by Koram, K. A. Articles by Molyneux, M. E.

When Is "Malaria" Malaria? The Different Burdens of Malaria Infection, Malaria Disease, and Malaria-Like Illnesses

In this review we discuss the different meanings of the term ‘malaria’ and urge writers and readers to distinguish accurately between them. The distinction is important in clinical practice, clinical trials, epidemiology, and the evaluation of control programs. Both over- and underdiagnosis of malaria as the cause of a disease episode are inevitable; overdiagnosis is common in high-transmission areas and underdiagnosis is common in areas with little or no transmission. Parasite density thresholds, attributable fractions, and clinical algorithms have played important but only partial roles in strengthening diagnosis. Methods by which malaria infection could be confidently identified as the cause, rather than an irrelevant accompaniment, of an illness, are important targets for research. One such ‘signature’ is a distinctive retinopathy that occurs in severe malaria and not in clinically similar diseases. Other indicators of a malarial etiology of clinical disease are needed to strengthen clinical and scientific approaches to the control of malaria.

Received October 31, 2006. Accepted for publication January 18, 2007.

^* Address correspondence to Malcolm E. Molyneux, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi. E-mail: mmolyneux{at}malawi.net

Authors’ addresses: K. A. Koram, Dept. of Epidemiology Noguchi Memorial Institute for Medical Research College of Health Sciences, University of Ghana, Legon. M. E. Molyneux, Malawi-Liverpool-Wellcome Trust Clinical Research Programme College of Medicine, University of Malawi. E-mail: mmolyneux{at}malawi.net

This article has been cited by other articles:

				J. G. Breman and C. N. Holloway Malaria Surveillance Counts Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): 36 - 47. [Abstract] [Full Text] [PDF]

				J. G. Breman, M. S. Alilio, and N. J. White Defining and Defeating the Intolerable Burden of Malaria III. Progress and Perspectives Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): vi - xi. [Full Text] [PDF]